Exploring Experiences of Disempowerment in Older Adults with Chronic Illness: A Qualitative Study.

BACKGROUND AND OBJECTIVES: Disempowerment in the context of chronic illness refers to the state of dissatisfaction with diminishing opportunities to control personal lives, potentially leading to disengagement in health management and negative health outcomes. However, the experiences and perceptions of disempowerment in chronic illness among older adults are not fully understood. This study aims to explore the experiences and perceptions of disempowerment in older adults with chronic illness. RESEARCH DESIGN AND METHODS: Qualitative description was employed. From January to March 2025, individual face-to-face semi-structured interviews were conducted with 18 Cantonese-speaking older adults with chronic illness. Template analysis was used. RESULTS: Three themes emerged regarding the experiences of disempowerment: (1) confusion and uncertainty amid unexpected changes and unclear information, (2) struggles to manage their health in the way they would like, and (3) difficulty in living the life they had before or had hoped for. Negative feelings towards the experiences were also identified with indirect expression to others. The causes included: (1) irreversibly declining health and intrinsic capacity, (2) unmet expectations, and (3) age discrimination. The consequences involved: (1) disengaging the context of disempowerment by suppressing negative emotions, distancing themselves from care partners, and trying to overcome the situation, followed by (2) accepting or despairing over time. DISCUSSION AND IMPLICATIONS: This study revealed the experiences and perceptions, causes and consequences of disempowerment in older adults with chronic illness. The tendency to indirectly express or suppress the negative feelings underscores a need for tailored strategies to better assess and address disempowerment in this population.